With the 1.11 release of Oscar Pro, we're updating the look of the monthly Roster Capitation reports (RCX) as well as adding some new functionality to keep your patient enrollment data accurate with a minimum of effort.
This automation greatly reduces and even eliminates the need for manual work when reconciling and updating patients' Enrollment Statuses and related data.
Accessing an RCX report file
These files come automatically from the ministry of health each month, similar to your remittance advice (RA.) As such, you can access them in the same way, by navigating to the Admin > Billing > View MOH Files section of Oscar Pro and clicking on the file name.
Reading the report
The report is broken down into five main sections. The header is always visible, and you can click any of the four section names to see that portion of the report.
A header with some static information about the report, like the provider, date, and totals of demographics included.
The Newly Rostered section, which shows patients who have local demographic files, but are newly rostered to the report provider.
The De-Rostered section, which shows patients who were previously rostered, but have been terminated or otherwise left the roster this month.
The Missing from EMR section, which shows patients who are included in the roster report, but do not have a matching local demographic file.
The Unchanged section, which shows patients who have been rostered to the provider previously. This will typically be the largest section by far.
Each section has information relevant to that section next to each patient, including DOB, roster duration, termination codes etc. You can click on the patient name to access their demographic file, with one notable exception.
Adding missing demographics
From the Missing from EMR column, clicking on the patient name will have a different effect, opening the 'add a demographic' menu and pre-filling information found on the report.
This portion of the RCX feature will be expanded on in a future release.
Reconciling the roster
Finally, the most important function of the report is automatically updating your local demographics with the reported enrollment information. This is as simple as clicking the Reconcile button at the bottom of the window.
The Reconcile button will do the following:
- Update the enrollment information for Newly Rostered demographics, including adding entries to their enrollment history.
- Update the enrollment information and termination date for De-Rostered demographics, including adding entries to their enrollment history.
- Update the enrollment information for Unchanged demographics, including adding entries to their enrollment history.
The Reconcile button will not do the following:
- Add demographics which are Missing from EMR
- Update demographics which have previously been updated by the same report already, or expand their enrollment history.